Civic Tech: For clues about Sidewalk Labs’ plans on Toronto’s healthcare, look to NYC

A $20-million spinoff from Sidewalk will open an experimental clinic this year.

By Pam Sethi

Photo courtesy of Sidewalk Labs.

Sure, you’ve heard of Sidewalk Labs—but what about their spin-off, Cityblock? Under Sidewalk Labs’ plan for Toronto’s eastern waterfront, the Quayside will become a test bed for all manner of experimentation and innovation, including healthcare. What does that actually mean in practice? The Quayside district will create an opportunity to discover how a city could be built to support health and well-being. There are few details at this point, and that’s where Cityblock comes in.

Cityblock is a health services start-up, a spin-off company that was once based in Sidewalk Labs’ offices though now operating independently. The company recently closed a $20-million fundraising round, and within the year plans to begin operating “Neighbourhood Health Hubs” in and around New York City.

Cityblock’s mission is to “radically improve the health of urban communities, one block at a time,” through a focus on preventative care. Cityblock intends to improve “misaligned payment incentives, siloed medical and social service delivery, and fragmented data” that have resulted from the failures of the U.S. healthcare system when it comes to the needs of low-income users.

Cityblock has also developed a technology platform called Commons, designed to improve workflow and communication (e.g. telehealth), but, it also functions as a comprehensive electronic medical record integrating various types of health and community data sources. Other features include personalized care team available 24/7, technology-supported member plans, and a community health partner to help members navigate their care. In essence, Cityblock hopes to operate a clinic that does more than provide medical services but supports a range of preventative resources, including social services, access to affordable housing, and so on for people covered by Medicare or Medicaid.

Sidewalk Labs has similar goals in Toronto. Sidewalk Toronto’s health care pilot will aim to develop a more active and healthy community, which could produce cost savings to the Canadian health system. Sidewalk Toronto’s project vision document includes feasibility studies that propose ways to integrate health and wellbeing into the day-to-day experience within the built environment.  

This includes plans to create an “expansion of hyper-local pop-up clinics” with an aim to make access to “healthcare more convenient,” and to serve as one-stop-shops for community services. Its intent is to test new health care models by partnering with innovative leaders in the field, and incorporating new regulatory approaches to healthcare and social service delivery.

So, how else can Sidewalk Labs improve on our pre-existing public health system?

If Cityblock is any indication, the key lies in improving non-medical social determinants of health, which play a key role in maintaining healthy populations—things like unstable income, social exclusion, food insecurity, poor education, and inadequate housing.

But most would contend that government is the one responsible for mitigating these issues. Low-income, racialized or Indigenous people have worse health outcomes compared to the Canadian average, so any intervention, public or private, should prioritize these demographics. Will Sidewalk Labs’ intervention help these communities who face barriers, or only those who can afford to live in Quayside condos?

Here are a few ideas that Sidewalk Labs could consider to promote a healthy urban and community development Toronto:

1. Understand it:  We have unique and defining values on healthcare—we care about it and we are protective of it. Develop a clear understanding of the Canadian and provincial health care systems, and respect the values and principles that have shaped it (i.e. Medicare, standards from the Canada Health Act, OHIP, TRCC, other policies and programs), such that the project enhances and adds to our existing publicly funded healthcare system.
2. Engage and Listen: Engage public health experts at all levels, especially local. Our public health system is quite different than in the United States—and those differences need to be accounted for in the development.
3. Fair Approach: Our health community has developed certain guidelines around health equity, so it’s important to apply this lens in the early phases of ideation, when creating new tech solutions or improved models of care that address equity-related factors.
4. Be open: Engage honestly and transparently with citizens to understand their health needs, and open access to previous Sidewalk Labs studies and reports. Consider innovative ways to ensure inclusive participation and engagement.
5. Protect our privacy: Make sure privacy of personal health data is guaranteed, develop a clear understanding of practices to protect health information, collection, use as well as access

Sidewalk Toronto has one year to create the roadmap and innovation plan for the health service solutions within the confines of its smart city. The time to influence this process is now. Health first and health equity approaches must be centre stage in any proposal. Good health is not a luxury of the few, but a right for all. There may still be a lot of questions, unknowns and plans to iron out, but as a way forward, Sidewalk Labs has a strong chance at making Toronto healthier, more equitable that we all strive towards.

Thanks for reading this instalment. Next up will be Nasma Ahmed with some thoughts on digital justice.